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Electroencephalographic activity in children under enflurane anesthesia.

I Rosén, M Söderberg

    Acta Anaesthesiologica Scandinavica
    |January 1, 1975
    PubMed
    Summary

    Pediatric patients undergoing enflurane anesthesia may experience electrographic seizure activity, particularly with moderate hypocapnia (low CO2 levels). This seizure risk increases at enflurane concentrations of 3% or higher.

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    Area of Science:

    • Anesthesiology
    • Pediatric Neurology
    • Neurophysiology

    Background:

    • Enflurane is an anesthetic agent used in pediatric patients.
    • Central nervous system excitability can be affected by anesthetic agents and blood gas levels.
    • Previous studies in adults indicated potential for increased central nervous system excitability with enflurane.

    Purpose of the Study:

    • To investigate the occurrence of electrographic seizure activity in children under enflurane anesthesia.
    • To assess the relationship between enflurane concentration, PaCO2 levels, and seizure activity in pediatric patients.

    Main Methods:

    • Recorded electroencephalogram (EEG), end-tidal CO2, electromyography (EMG), eye movements, and electrocardiogram (ECG) in 17 children.
    • Administered enflurane anesthesia combined with nitrous oxide (N2O) and oxygen (O2).

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  • Monitored spontaneous and controlled ventilation, including periods of hyperventilation.

    • Main Results:

    • Generalized high-voltage epileptic activity (grand mal type) occurred in 3% of subjects with PaCO2 below 32 mmHg at 4% enflurane.
    • Electrographic seizure activity (poly-spike-suppression type) was observed in 3 out of 8 subjects at 3% enflurane.
    • Motor manifestations accompanied electrographic seizures in some cases, particularly with PaCO2 levels around 31 mmHg.

    Conclusions:

    • Electrographic seizure activity is a common finding in children receiving enflurane anesthesia at concentrations of 3% or higher, especially with moderate hypocapnia.
    • Hypocapnia appears to be a significant factor contributing to seizure activity during enflurane anesthesia in pediatric populations.
    • These findings highlight the importance of monitoring blood gas levels during enflurane anesthesia in children to mitigate seizure risks.